The present invention relates to a method for treating inflammatory skin disease and more particularly to a novel method for treating human skin infected with viral infections such as, for example, Herpesvirus, as well as the treatment of other infections of the skin where inflammation is a problem.
By inflammation is meant the destruction and repair of the tissues in response to irritation, and the means whereby the irritant is removed.
Such a definition places no limits on the amount of the response or the degree or kind of irritation. Because irritation by the normal products of growing and dying cells is related to the process of intercellular communication that occurs physiologically, inflammation merges with the normal behavior of tissues. When minimal it may differ only in degree from the normal physiological process by which tissues control their requirements from their blood supply.
Inflammation is necessary for repair as well as for the removal of irritants. However, repair, as in wound healing, differs only quantitatively from those processes which control the normal growth and contour of the tissues.
Swelling of the tissues is initially due to edema fluid, but in more chronic inflammation white cells infiltration may make a main contribution. The tissues themselves often increase in size. Thus acanthosis and an increase in the papillary vasculature is a usual response of the epidermis and upper dermis to irritation. A papular lesion following an insect bite may show a considerable increase in the bulk of the tissue which may persist after the initial edema has been resolved. Pseudo-epithiliomatous hypertrophy is not unusual in uncontrolled inflammation.
Heat is a usual consequence of increased flow of blood through the skin. In acute lesions the skin may be heated as a direct result of a local increase in metabolic rate. In chronic inflammation neither local metabolism nor blood flow may be increased, and the skin may feel cold. Heat loss cannot be exactly correlated with redness, because, areas of fast flow may be on the border of a more congested and slow-flowing system. Thus conduction of heat to the surface of the skin may be considerable over a large, deep arceriovenous fistula while the upper dermis may show all the effects of severe stasis consequent on raised venous pressure.
The sensations that accompany inflammation of the skin include burning, stinging, itching and tenderness, and are thus more varied than in most internal organs. Which of these sensations predominates depends in part on the site, depth, intensity and duration of the inflammatory process. Thus in urticaria stinging may accompany transient superficial lesions, itching is the usual sensation in papular urticaria or in lesions due to histamine release, while pain and tenderness may accompany deeper lesions of long duration, as in delayed pressure urticaria.
Inflammation is a response to any irritation, and the mechanism applies equally to infection, sunburn, abrasions, contact dermatitis or the various patterns or angiitis seen in dermatological practice. Studies of the effects of injury to the skin show early and delayed phases of the inflammatory response, and these are similar whether induced by trauma such as pressure or by ultraviolet irradiation, or any of the factors listed.
It would, be extremely desirable to provide an effective treatment for inflammatory skin diseases. Moreover, it would be desirable to provide an improved treatment for Herpesvirus disorders such as eczema, which is safe, having no known side effects in any body locations. Such treatments are described and claimed herein.
Herpesviruses come in 70 different varieties, but only a few are infectious to humans. The viruses infectious to humans include Herpesvirus hominis, which causes herpes simplex; Herpesvirus varicallae, which causes varicella (chicken pox) and zoster (shingles); the Epstein-Barr virus, which causes mononucleosis; and cytomegalovirus, which causes fetal infections. Herpesviruses are also often responsible for fevers, hepatitis, and pneumonia-like illnesses in children and adults, especially those with lowered resistance. Additionally, eczema is caused by Herpesvirus hominis or Poxvirus officinalis, and perhaps other viruses such as Coxsackievirus.
A. Herpes Simplex
Of all the Herpesviruses, the effects of Herpesvirus hominis are by far the most commonly experienced. Herpesvirus hominis, which is responsible for herpes simplex, has two different forms: Type I and Type II. Type I causes Herpes labialis (oral herpes) in the form of cold sores and unsightly lesions around the lips or nose. Type II causes Herpes genitalis (genital herpes) in the form of sores that appear below the waist, primarily in the genital area. The two types vary little with respect to the nature of their behavior and either one can take the other's place. Thus, Type II can cause a cold sore while Type I can also infect the genitals. Nevertheless, Type II is responsible for at least about eighty percent (80%) of genital herpes.
Both types I and II can be transmitted by sexual as well as non-sexual contact; however, genital herpes is generally transmitted through sexual intercourse. A Type I infection of the genitals or a Type II infection of the mouth can occur through oral-genital contact. A cold sore virus may be transmitted when two persons kiss or by means as simple as the use of the same towel to wipe their faces. The eyes can be infected simply by rubbing them after touching an infected area. Thus, there are a variety of ways in which herpes simplex viruses I and II can be transmitted. Moreover, although not the usual case, transmission of the viruses can even occur before the symptoms of herpes simplex appear or before the infected person is aware that he or she has herpes simplex.
The symptoms of herpes simplex infections include the development of a cluster of tiny bumps or blisters, sometimes preceded or accompanied by a fever or swollen lymph glands. The blisters then crust over, and the sores disappear--usually within three weeks after the first symptoms. However, the virus remains in the body for a lifetime, hibernating in such places as the salivary glands, the nerve tissue, and the lymph nodes. After recovery from the first attack, subsequent infections may occur over the next few years, until gradually the frequency of attacks diminishes. Occasionally, however, recurrences may appear over the rest of the individual's life. The reappearance of herpes infections is then often triggered by stress, fatigue, exposure to sun, trauma, fever or menstruation.
Other complications may develo in those who are afflicted with a herpes simplex virus. If a person suffering from herpes simplex touches a sore or blister and then rubs his eyes, he may develop a serious eye infection known as herpes keratitis. Thousands of Americans annually lose their sight because of this disease.
For women, genital herpes simplex carries special risks. To begin with, genital herpes simplex has been linked to cancer of the cervix. Female herpes victims are five to seven times more likely to develop cervical cancer than non-infected females. Genital herpes simplex can also cause serious birth defects. A pregnant woman with an active genital herpes simplex infection faces a fifty percent (50%) chance of passing the disease to her baby as the child passes through the birth canal. About fifty percent (50%) of the newborn infants who develop herpes simplex die of the infection; seventy-five percent (75%) of those who survive suffer from blindness or brain damage. Fortunately, if sores are found close to the time of delivery, the doctor can perform a Caesarean-section to prevent infection of the newborn as it passes through the birth canal.
Most Americans have been exposed to the herpes simplex virus; indeed, eighty percent (80%) of the American population carries the herpes simplex virus, and antibodies against the virus have been found in up to ninety-five percent (95%) of blood samples tested. Although some people never experience symptoms, (possibly because their immune systems repulse the virus so it cannot sustain its attack), about seven out of eight people who come in sexual contact with the herpes simplex virus will contract an infection. It is estimated that from thirty (30) to seventy (70) million Americans suffer occasionally from the most common form of herpes simplex infection, that of coldsores. Moreover, it is estimated that from five (5) to twenty (20) million Americans suffer from genital herpes simplex, and that each year, half a million more Americans join these ranks.
Since there has previously existed no known effective treatment for herpes simplex, the total number of persons inflicted with herpes simplex continues to increase. Scientists have tried and rejected many different treatments for herpes such as vitamin C, zinc, ether, and ice packs. It is evident that in the absence of a treatment for herpes simplex, this relatively new veneral disease could potentially reach epidemic proportions.
B. Eczema
Another Herpesvirus disorder which plagues many people is atopic eczema. Eczema occurs in primarily three forms: (1) the infantile form, (2) the adult form, and (3) the localized form.
The infantile form of eczema may first appear soon after birth, often by the fourth month of the infant's life. Infantile eczema is generally mainfested as processes which may be red, dry, slightly scaly, cracked, and excoriated, or sometimes moist and oozing. Infantile eczema is most frequently manifested around the face, scalp, neck, and diaper areas. Older children and young adults generally experience manifestation of the disease in the flexural areas and the cheeks. In fewer than half of the individuals inflicted with infantile eczema, the disease clears up by the age of four; yet even in these individuals, the disease may occur at a later age. The majority of eczema victims still experience occasional flare ups through the young adult years, up until about the age of thirty, at which time the disease usually disappears.
The adult form of eczema is generally manifested in the antecubital and popliteal areas, and in some cases around the hands, feet, and face. The infected skin is generally dry, erythematous, and excoriated with bacterial crusting and redness.
The localized form of eczema, which occurs in diverse individuals, is primarily manifested around the wrists, ankles, hands, feet and ears, as well as the perianal, perivulvar, adn scrotal regions.
By far the worst consequence of atopic eczema is the pruritis or itching which is associated with this disease. Those inflicted with atopic eczema often find pruritis to be a life-long companion. Any relief to be had from such intolerable itching is gratifying to say the least. There are many factors which play a role in the occurrence of atopic eczema, such as dietetic and emotional factors. Moreover, seasonal fluctuations are an important factor with atopic eczema generally becoming worse during the winter season.
One of the greatest fears of those who are inflicted with atopic eczema, is that these individuals are generally more susceptible to viral infection, and in particular, to infestation by a herpes simplex virus or a vaccinia virus. Additionally, those suffering from atopic eczema are abnormally susceptible to environmental irritants. Consequently, those inflicted with the disease are often advised to wear clothing which is soft and light; to stay away from heat sources; to take brief baths or showers not exceeding five minutes and using a minimal amount of soap; to avoid primary irritants such as paints, cleansers, solvents, chemical sprays, dusts, and the like; and sometimes to change their residence to a warm, dry temperature, unvarying climate where temperature extremes are rarely experienced.
Although there is no known cure for atopic eczema, there are various helpful treatments which all have one goal in common: to stop the intolerable itching that accompanies atopic eczema. Examples of these treatments include antiseptics, for example antibacteral cleansers such as Betadine (a registered trademark owned by Purdue Frederick Co.; Norwalk, Conn. 06856) and Hibitaine; topical glucocorticoid creams; systemic glucocorticoids; antipruritic agents; and antibiotics. Although the atopic and systemic glucocorticoid treatments have proven most effective in treating long-continued atopic eczema, adverse topical and systemic effects are often experienced when such treatments are used. Consequently, adverse effects in those undergoing glucocorticoid treatments must be carefully monitored.